Endocrinol Metab.  2023 Apr;38(2):269-276. 10.3803/EnM.2022.1588.

Association between N-Terminal Prohormone Brain Natriuretic Peptide and Decreased Skeletal Muscle Mass in a Healthy Adult Population: A Cross-Sectional Study

• Yoo TK
• Wu MYC
• Kim MS
• Lee MY
• Lee YT
• Yoon KJ
• Park CH

• KMID: 2541883
• DOI: http://doi.org/10.3803/EnM.2022.1588

Abstract

Background
Although an inverse association between the N-terminal prohormone brain natriuretic peptide (NT-proBNP) and obesity exists, only few major studies have assessed the association between NT-proBNP levels and skeletal muscle mass in asymptomatic healthy adults. Therefore, this cross-sectional study was conducted.
Methods
We assessed participants who underwent health examinations at Kangbuk Samsung Hospital in South Korea from January 2012 to December 2019. Appendicular skeletal muscle mass was measured using a bioelectrical impedance analyzer, and the skeletal muscle mass index (SMI) was calculated. Participants were divided into the control, mildly low skeletal muscle mass (LMM) (−2 standard deviation [SD] < SMI ≤−1 [SD]), and severely LMM groups (SD ≤−2) based on their SMI. The association between elevated NT-proBNP level (≥125 pg/mL) and skeletal muscle mass was assessed using multivariable logistic regression analysis with adjustment for confounding factors.
Results
This study enrolled 15,013 participants (mean age, 37.52±9.52; men, 54.24%; control, n=12,827; mildly LMM, n=1,998; severely LMM, n=188). Prevalence of elevated NT-proBNP was higher in mildly and severely LMM groups than in the control group (control, 1.19%; mildly LMM, 1.4%; severely LMM, 4.26%; P=0.001). The adjusted odds ratio (OR) of elevated NT-proBNP was significantly higher in severely LMM (OR, 2.87; 95% confidence interval [CI], 1.3 to 6.37) than in control (OR, 1.00; reference) or mildly LMM groups (OR, 1.24; 95% CI, 0.81 to 1.89).
Conclusion
Our results showed that NT-proBNP elevation were more prevalent in participants with LMM. In addition, our study showed an association between skeletal muscle mass and NT-proBNP level in a relatively young and healthy adult population.

Keyword

Natriuretic peptide, brain; Muscle; Sarcopenia

Figure

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  Fig. 1. Flow diagram of study participants. NT-proBNP, N-terminal prohormone brain natriuretic peptide.

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  Fig. 2. Comparison of adjusted mean of ln(N-terminal prohormone brain natriuretic peptide [NT-proBNP]) between normal, mildly low skeletal muscle mass (LMM), and severely LMM groups. Comparison of adjusted mean±standard error of natural-log transformed NT-proBNP levels in the groups was estimated using analysis of covariance (ANCOVA) after adjusting for the following confounding factors: age, sex, health examination center, systolic blood pressure, glucose, smoking, heavy alcohol consumption (>30 g/day), regular exercise, and high-density lipoprotein cholesterol level. Group difference was assessed by Bonferroni post hoc P<0.001.

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